Revenue Cycle Representative-Pharmacy Billing Office at University of Iowa in Iowa City, Iowa

Job Description:

Position Summary


The Department of Pharmaceutical Care intends to hire a Revenue Cycle Representative. The Revenue Cycle Representative is a financial position in the healthcare industry necessary for hospital and pharmacy billing practices. This position requires strong computer skills, a high level of attention to detail and a general knowledge of hospital and prescription billing practices. The Revenue Cycle Representative will work closely with other staff within the department to support pharmacy revenue management (i.e., benefits investigation, prior authorization support and copay assistance) and complete routine pharmacy billing activities.


Position Responsibilities



Patient Revenue Management:

• Review pharmacy transactions and submit claims to insurance and/or third-party payors.
• Assist patients and staff with troubleshooting insurance claim issues, benefits investigation and enrollment of patients into pharmacy services (i.e., specialty pharmacy).
• Communicate with patients, pharmacists and/ or providers to gather relevant demographic information.
• Initiate and follow through for required prior authorizations.
• Assist with copay/coinsurance assistance when applicable.
• Communicate with patients, insurance companies, credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries.
• Appeal/troubleshoot claim payments and/or denials using available resources.
• Monitor reimbursement activity for medications to ensure UI Health Care receives full and accurate reimbursement for pharmacy services in compliance with payor rules and regulations.
• Monitor compliance standards and policies to ensure UI Health Care receives full and accurate reimbursement for services in compliance with payor rules and regulations.
• Complete routine billing office responsibilities
• Process refunds
• Billing adjustments
• Monthly statement process
• Collect payments
• Other duties as they arise
• Provide the highest customer service experience for patients and providers.

Operations and Performance Standards:

• Utilize tools and processes to maximize the efficiency of the revenue cycle.
• Resolve pharmacy billing discrepancies and identify possible trends.
• Identify areas to improve the billing process.
• Comply with established cash handling policies and procedures of the institution and department.
• Assist with the evaluation and implementation of new products/technology.
• Assist with the evaluation and implementation of new policies and procedures.
• Participate in standard pharmacy operations as the need arises.

Reporting:

• Analyze and prepare routine reports to identify trends and aid in making financial decisions.
• Compile information for audits as they arise from compliance and insurance/third party payors in a reportable manner.
• Report discrepancies found during report analysis.
• Document activities required by accrediting agencies, payors and/or administration (i.e., workload statistics, phone statistics, etc.).

Communication/Training:

• Communicate with providers, payors, patients, co-workers, supervisors and departments to resolve revenue cycle issues.
• Understand the importance of effective business communication and maintaining professionalism in difficult situations.
• Participate in orientation of pharmacy technicians, pharmacists, pharmacy residents and others within the department on pharmacy billing practices.
• Other duties as assigned.

Education Requirements:

• Completion of a bachelor's degree or equivalent combination of education and experience.
• Successful completion of the pharmacy technician certification exam within twelve months of the start of employment.
• Must registered with Iowa Board of Pharmacy prior to commencing employment.

Experience Requirements:

• Previous experience in customer service.
• Experience and proficiency with computer software applications (i.e., Microsoft Office Suite - Word, Excel, Outlook, PowerPoint) or comparable programs.
• Strong attention to detail and proven ability to gather and analyze data and keep accurate records.
• Self-motivated with initiative to seek out additional responsibilities, tasks and projects.
• Effective verbal and written communication skills, active listening skills and the ability to maintain professionalism while handling difficult situations.
• Demonstrate ability to follow policies and procedures while escalating issues as needed.
• Familiarity with medical terminology.

Desired Qualifications:

• Experience working in a complex hospital system is desirable.
• Experience working in a collaborative team environment is desirable.
• Pharmacy experience is desirable.
• Basic knowledge of healthcare billing, experience working with insurance and/or federal and state assistance programs is desirable.
• Working experience with multiple technology platforms (i.e., Epic, GE) is desirable.
• Basic knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA) is desirable.

Position and Application details:


In order to be considered for an interview, applicants must upload the following documents and mark them as a "Relevant File" to the submission:

• Resume
• Cover Letter

Job openings are posted for a minimum of 14 calendar days and may be removed from posting and filled any time after the original posting period has ended.

Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. Up to 5 professional references will be requested at a later step in the recruitment process.

For additional questions, please contact Regan Lampe at regan-lampe@uiowa.edu


Additional Information

• Classification Title: Revenue Cycle Representative
• Appointment Type: Professional and Scientific
• Schedule: Full-time

Compensation

• Pay Level: 2B

Contact Information

• Organization: Healthcare
• Contact Name: Regan Lampe
• Contact Email: regan-lampe@uiowa.edu

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